--- title: "Symptoms & functional impairment in early psychosis | Sutter Health" description: "Despite high rates of depression and anxiety in early psychosis, few studies have examined the contribution of these symptoms to functioning in the putative 'prodrome.'" url: "https://www.sutterhealth.org/research/publications/symptoms-functional-impairment-in-early-psychosis-1055312610" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Symptoms & functional impairment in early psychosis # Symptom dimensions and functional impairment in early psychosis: more to the story than just negative symptoms. Fulford D, Niendam TA, Floyd EG, Carter CS, Mathalon DH, Vinogradov S, Stuart BK, & Loewy RL. _Schizophr Res. 147(1):125-31. doi: 10.1016/j.schres.2013.03.024. Epub 2013 Apr 12._ 2013-06-01 ## Abstract Functional impairment is a defining feature of psychotic disorders and usually appears well before their onset. Negative symptoms play a prominent role in the impaired functioning of individuals with schizophrenia and those at clinical-high-risk (CHR) for psychosis. Despite high rates of depression and anxiety in early psychosis, few studies have examined the contribution of these symptoms to functioning in the putative 'prodrome.' In the current study, we tested the hypotheses that 1) worse negative and disorganized, but not positive, symptoms would be significantly related to impaired social and role functioning in two cohorts of CHR individuals (combined N=98) and a separate sample of individuals with recent-onset (RO) psychotic disorders (N=88); and 2) worse anxiety and depression would be significantly related to impaired functioning in both samples, above and beyond the contributions of negative and disorganized symptoms. Findings largely supported our hypotheses that more severe negative and disorganized symptoms were related to poorer social and role functioning in both samples. Anxiety and depression severity were significantly related to poorer functioning in both samples. In addition, depression, but not anxiety, predicted poorer global and social functioning above and beyond that explained by negative symptoms in the CHR sample. These results suggest the need for phase-specific treatment in early psychosis, with a focus on symptom dimensions to improve functional outcomes for CHR individuals. ## Research topics - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Ecological Momentary Assessment of social functioning in schizophrenia: impact of performance appraisals and affect on social interactions.](https://www.sutterhealth.org/research/publications/assessment-of-social-functioning-in-schizophrenia-1055312626) Granholm E, Ben-Zeev D, Fulford D, Swendsen J. Schizophr Res. 145(1-3):120-4. doi: 10.1016/j.schres.2013.01.005. Epub 2013 Feb 10. 2013 Apr 01 - Publication ### [The double-edged sword of goal engagement: consequences of goal pursuit in bipolar disorder.](https://www.sutterhealth.org/research/publications/consequences-of-goal-pursuit-in-bipolar-disorder-1055312605) Johnson SL, Fulford D, Carver CS. Clin Psychol Psychother. 19(4):352-62. doi: 10.1002/cpp.1801. Epub 2012 May 21. Review. 2012 Jul 01 - Publication ### [Symptom assessment in early psychosis: The use of well-established rating scales in clinical high-risk and recent-onset populations.](https://www.sutterhealth.org/research/publications/symptom-assessment-early-psychosis-rating-scales-1055312798) Fulford D, Pearson R, Stuart BK, Fisher M, Mathalon DH, Vinogradov S, Loewy RL. Psychiatry Res. 220(3):1077-83. doi: 10.1016/j.psychres.2014.07.047. Epub 2014 Aug 1. 2014 Dec 30 - Publication ### [Pushing and coasting in dynamic goal pursuit: coasting is attenuated in bipolar disorder.](https://www.sutterhealth.org/research/publications/coasting-is-attentuated-in-bipolar-disorder-1055312618) Fulford D, Johnson SL, Llabre MM, Carver CS. Psychol Sci. 21(7):1021-7. doi: 10.1177/0956797610373372. Epub 2010 Jun 2. 2010 Jul 01 - Publication ### [John & Marcia Goldman Foundation Donates $100K to Improve Behavioral Health in Teens](https://www.sutterhealth.org/research/publications/teen-behavioral-health-care-1055312809) Palo Alto Medical Foundation Marketing & Communications, Jan. 15, 2015 Palo Alto Medical Foundation Newsroom Blog 2015 Jan 15 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/symptoms-functional-impairment-in-early-psychosis-1055312610#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Symptoms & functional impairment in early psychosis"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/symptoms-functional-impairment-in-early-psychosis-1055312610#medicalscholarlyarticle","name":"Symptom dimensions and functional impairment in early psychosis: more to the story than just negative symptoms.","headline":"Symptoms & functional impairment in early psychosis","abstract":"Functional impairment is a defining feature of psychotic disorders and usually appears well before their onset. Negative symptoms play a prominent role in the impaired functioning of individuals with schizophrenia and those at clinical-high-risk (CHR) for psychosis. Despite high rates of depression and anxiety in early psychosis, few studies have examined the contribution of these symptoms to functioning in the putative 'prodrome.' In the current study, we tested the hypotheses that 1) worse negative and disorganized, but not positive, symptoms would be significantly related to impaired social and role functioning in two cohorts of CHR individuals (combined N=98) and a separate sample of individuals with recent-onset (RO) psychotic disorders (N=88); and 2) worse anxiety and depression would be significantly related to impaired functioning in both samples, above and beyond the contributions of negative and disorganized symptoms. Findings largely supported our hypotheses that more severe negative and disorganized symptoms were related to poorer social and role functioning in both samples. Anxiety and depression severity were significantly related to poorer functioning in both samples. In addition, depression, but not anxiety, predicted poorer global and social functioning above and beyond that explained by negative symptoms in the CHR sample. These results suggest the need for phase-specific treatment in early psychosis, with a focus on symptom dimensions to improve functional outcomes for CHR individuals.","description":"Despite high rates of depression and anxiety in early psychosis, few studies have examined the contribution of these symptoms to functioning in the putative 'prodrome.'","keywords":["Mental Health"],"datePublished":"2013-06-01","url":"https://www.sutterhealth.org/research/publications/symptoms-functional-impairment-in-early-psychosis-1055312610","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"DOI","value":"10.1016/j.schres.2013.03.024"}],"sameAs":["https://doi.org/10.1016/j.schres.2013.03.024"],"isPartOf":{"@type":"Periodical","name":"Schizophr Res"},"author":[{"@type":"Person","name":"Fulford D"},{"@type":"Person","name":"Niendam TA"},{"@type":"Person","name":"Floyd EG"},{"@type":"Person","name":"Carter CS"},{"@type":"Person","name":"Mathalon DH"},{"@type":"Person","name":"Vinogradov S"},{"@type":"Person","name":"Stuart BK"},{"@type":"Person","name":"Loewy RL"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Mental Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Mental+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/symptoms-functional-impairment-in-early-psychosis-1055312610","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/symptoms-functional-impairment-in-early-psychosis-1055312610#breadcrumblist"}}} ```